Movember 2025: International Men's Day and the Mortality Sex Gap
Oh, It's Hard to be a Man
Today is International Men’s Day.
And while some of the above is due to men having, shall we say, deserved it (sorry, the violent crime… sometimes involves a victim who was a bit slower on the draw, shall we say. It sucks, and I will say a bit more about that in a bit), in many of these cases, it’s true. Unfortunately, some think that the point is to let everybody out… no, sorry, I don’t think that’s the answer. The point is to be fair.
But before I get into a recent report that had my blood boiling over their concept of gender equity in life expectancy:
Movember Fundraising Links
Here are the places you can donate to the Movember Foundation, which supports men’s health, specifically focusing on prostate cancer, testicular cancer, and men’s mental health:
Mary Pat Campbell’s MoSpace – a place to donate at Movember itself
My Movember Facebook fundraiser – my officially linked fundraiser, if this works better for you
And here’s a QR code if that works better for you:
Reality Check on International Men’s Day: a Report Assuming Men SHOULD Die 5 Years Earlier
When I saw the following, my jaw about dropped.
It came via a post from Richard V. Reeves’s substack, Of Boys and Men, which I highly recommend:
But here is Reeves’s excerpt first:
I’ve a new research paper out at AIBM, “Beyond half measures: how to improve gender gap indices”. It’s something I’ve noodled with for years, and only been able to land with the analytical expertise of my co-author Allen Downey. It’s an empirical paper, but the basic underlying point of it is this: measures of gender gaps should measure gender gaps both ways, both when boys and men are at a disadvantage relative to girls and women, as well as vice versa.
I agree with Reeves on all the points that follow. I have no issue with his concept. (He also fundraises for Movember, I note.) What got me angry was not Reeves, but what he was reacting to.
But a measure of the overall gender gaps in a society should, in our view, be symmetrical. Unfortunately that is not the case for the most-cited international measure, the Global Gender Gap Report (GGGR) from the World Economic Forum. The Report is a huge data collection feat, and we want to acknowledge the work done by its authors.
I am not yet angry… it’s coming.
I am jumping over a bunch of stuff that Reeves focuses on, but getting to my area of expertise: mortality.
Big, varied gender gap in life expectancy
The GGGR also considers gender gaps in healthy life expectancy. Here the problem is not only that gender gaps disfavoring men are discounted, but that a certain gender gap is assumed to be natural. As the GGGR report explains:
[I]n the case of healthy life expectancy the equality benchmark is set at 1.06 to capture the fact that women tend to naturally live longer than men. As such, parity is considered as achieved if, on average, women live five years longer than men.
This means that a country where men die only four years before women is considered to be unequal - to women. This is a problem, given that there is absolutely nothing natural about a five year difference in healthy life expectancy. A century ago, the life expectancy gap was just two years in the U.S., but has tripled since.
We don’t need to look back in time to make this point, we can just look around the world. The data collected for the GGGR itself shows that yes, women live longer in most countries, but that there is also massive variation:
Here is the graphic:
Women don’t live longer in “most” OECD countries
THEY LIVE LONGER IN ALL OF THEM.
(fine, except in the Netherlands, where there is no difference)
If you’re using period life expectancy from birth as your metric (they’re using something different: “Healthy life expectancy” — which is some years less than period life expectancy…and you may wonder why I keep saying the word “period”, and that’s me being pedantic, so just ignore me for now.)
But this is the part that got me angry. I didn’t highlight it above, but I’m going to do it now:
parity is considered as achieved if, on average, women live five years longer than men.
WHAT THE HELL
WHY
Look at the above countries.
Look at the countries where the males and females have almost identical healthy life expectancies:
The Netherlands (no difference)
Iceland (difference: 0.2 years)
Sweden (0.2)
Norway (0.3)
Switzerland (0.4)
Am I to understand that these countries have less equitable outcomes for women than for men, healthwise, because MEN DON’T DIE EARLY ENOUGH compared to the following countries:
Lithuania (6.1 years)
Latvia (5.7 years)
Estonia (5.2 years)
Poland (4.9 years)
Slovakia (3.9 years)
South Korea (3.6 years)
I’m not getting all the countries here — just picking a few.
Which of these countries — the first set, or the second set, would you bet were more equitable in their treatment of women, health-wise?
To be sure, women in South Korea do tend to live longer than those in the Netherlands… but, I don’t think it has anything to do with gender equity.
Neither South Korea nor Japan, the longest-lived of these groups, is known for its great treatment of women.
Geeking out: Mortality ratios of Males and Females by Cause of Death: U.S., 2023
Let’s look at the top causes of death in the U.S. in 2023, broken out by sex, and compare the death rates:
These are sorted in descending rate by males, but these are the major “rankable” causes you will see — and here’s the spreadsheet if you want to look at the underlying data, etc.
The story is in the death ratios.
There are very few causes of death for which females have a higher rate. Alzheimer’s is one of them. (This is not just a matter of age, by the way. These rates are age-adjusted.)
I want to highlight a few causes first:
“Accidental” causes
Suicide
Homicide
These three are the “external” aka non-natural or non-physiological causes of death.
Both suicide and homicide death rates are much higher for males than for females. About 3x - 4x. I’m not breaking it out by ages in this post.
But even for “accidental” causes - and I put that in scare quotes because yes, people did not intend to die when they were involved in various behaviors, however… males are more likely to be involved in certain risky behaviors such as drunk driving and taking drugs that are likely to end in deadly overdoses.
Yes, I do fundraise for men’s mental health and for support. We try what we can to build community… however, there is so much a health system can do.
(That’s true for women as well.)
But here’s a thing: in some countries, the rates for certain accidental causes of death with huge sex disparities (especially drug ODs and motor vehicle accident deaths) are much less likely to occur. I’ve talked w/ actuarial peers from other countries about these issues, and obviously it makes sense. Americans drive a lot more miles, and even if we didn’t drink & drive… we drive so many more miles, we have more risk exposure. (And the whole gun issue.)
One other large source of sex mortality difference is smoking rates — for many decades, there had been large differences in how much men and women smoked in the U.S. Now, very few men or women smoke in the U.S., so the disparities in lung cancer, emphysema, and other similar smoking-driven conditions are reduced going forward. But in some countries there may continue to be gaps, and in others there is parity.
Similarly, alcohol use. I note that the death rate due to “liver disease” — that’s mainly cirrhosis due to alcohol use. The ratio is close to 2x for male-to-female.
So yes, a lot of the differences in the U.S. are due to behavior, I will not deny.
HOWEVER
If we are to change the behavior, and get men to treat themselves better, it’s not going to help to frame the situation saying: the expectations are that men should die 5 years before women.
This is not correct.
It is correct only if you think that yes, it’s fine that they engage in self-destructive behaviors at much higher rates. (NO! BAD MULTINATIONAL ORGS! SWACK! NO TREAT FOR YOU!)
It’s one thing if men are more often involved in more dangerous occupations compared to women, to fulfill a dedication to a higher cause.
But there’s no higher cause in dying due to a fentanyl overdose.
It seems to me that those Nordic countries with little difference in healthy life expectancy between the sexes are just fine on gender equity.
I think the framing of a 5-year difference as being “natural” between the sexes is nonsense. For all of the seeking of proof for disadvantage for females in their treatment, it seems more likely to me that males are having it rough in those societies where they’re dying 5+ years earlier than females on average.
Because the other logic ain’t logicking.